Future Treatments for Multiple Myeloma

Roswell Park researchers are attacking multiple myeloma from many directions.  For example, we’re finding better ways to pinpoint where the disease is located in the body and measuring the effectiveness of a vaccine developed right here that stimulates your own immune system to fight the disease. 

Imaging Innovation

On a large scale, through clinical trials we’re using imaging techniques such as PET-CT and functional MRI to:

  • Accurately locate clusters of myeloma cells and areas of bone destruction in the body.
  • Understand how the disease is distributed through the body and how the different types of myeloma cells (which may be caused by different gene mutations) change over time.
  • Detect any disease remaining in the body after treatment, which might cause the multiple myeloma to return later on (recur).

Jens Hillengass, MD, Chief of Myeloma, has established new imaging techniques to better identify and measure the amount of bone destruction and find out how extensively the multiple myeloma cells have invaded the bone marrow. As a member of the International Myeloma Working Group (IMWG), he is developing new guidelines for the use of imaging in myeloma and other monoclonal plasma cell disorders. As a result of his discoveries, the IMWG now recommends using MRI results to identify multiple myeloma that requires systemic (whole-body) treatment.

Mining the Microenvironment

Roswell Park researchers were among the first to recognize that multiple myeloma can be attacked effectively with treatments that disrupt the microenvironment that allows the myeloma cells to grow. By developing new treatments that focus on the immune system and the microenvironment rather than just the cancer cell itself, we hope to improve survival rates and spare patients the side effects of chemotherapy. Specifically, we are trying to better understand the interaction between myeloma cells and the bone marrow environment, so we can develop a more powerful way to attack myeloma cells — not directly, but through the “soil” in which they grow.

  • We’re investigating markers — substances produced by cancer cells — to predict how the disease will progress (risk factors).
  • We’re identifying new targets (genes or proteins in the myeloma cells) so we can develop treatments aimed at those targets.
  • We’re finding better ways to detect small amounts of disease that remain after treatment, which can stand in the way of a cure.

We’re also working to develop new multiple myeloma treatments that focus on: 

  • New ways to stimulate your immune system to attack the myeloma cells:

    Kelvin Lee, MD, Chair of the Department of Immunology, is developing new strategies to combat multiple myeloma using vaccines developed and clinically tested by Roswell Park’s Center for Immunotherapy. The vaccines are combined with small-molecule drugs that can “wake up” the immune system so it will recognize the myeloma cells as harmful and destroy them.

    Dr. Lee also led a team that provided the first evidence that a specific cell surface receptor called CD28 is absolutely necessary for myeloma cells to survive. Our investigators are now studying new treatment methods that block the interaction between the CD28 receptor on multiple myeloma cells and the cells in the bone marrow microenvironment that help the cells grow. The goal: to kill cancerous plasma cells and make the remaining cells too weak to fight chemotherapy.
  • Understanding how the environment in the bone marrow supports the growth of multiple myeloma and finding ways to disable that support.
     
  • Determining the best timing for eligible patients to undergo bone marrow transplant (BMT).

Search for multiple myeloma clinical trials at Roswell Park.